Statements of Claimed Railroad Service and Earnings

ICR 199706-3220-001

OMB: 3220-0025

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
33828 Migrated
ICR Details
3220-0025 199706-3220-001
Historical Active 199403-3220-001
RRB
Statements of Claimed Railroad Service and Earnings
Revision of a currently approved collection   No
Regular
Approved without change 07/28/1997
Retrieve Notice of Action (NOA) 06/04/1997
  Inventory as of this Action Requested Previously Approved
07/31/2000 07/31/2000 07/31/1997
2,005 0 5,725
234 0 578
0 0 0

When RRB records indicate that railroad service and/or compensation is insufficient to qualify a claimant for unemployment or sickness benefits, the statements obtain information needed to reconcile the compensation and/or service on record with that claimed by the employee.

None
None


No

1
IC Title Form No. Form Name
Statements of Claimed Railroad Service and Earnings UI-9/UI-23, UI-44/ID-4F, ID-4U/ID-4X, ID-4Y/ID-20-1, ID-20-2/ID-20-4

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 2,005 5,725 0 141 -3,861 0
Annual Time Burden (Hours) 234 578 0 13 -357 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/04/1997


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